We now have a 10-year update of data from RTOG 9902, a clinical trial begun in 2000 and closed to accrual in 2004 because of excess toxicity. Although the study ended before it met its accrual goal, patients continued to be tracked. The study protocol included:

Before we write off adjuvant chemotherapy with radiation entirely, we must acknowledge that this clinical trial was begun before docetaxel (Taxotere) was shown to be active in the treatment of advanced prostate cancer. Docetaxel is far more effective and far less toxic than the chemotherapy used in this study. The study also used a radiation dose of only 70 Gy, which we now know to be inadequate for high-risk patients.

So far, all we can conclude is that we don’t have enough evidence to change the standard of care to include chemotherapy with radiation + ADT.

Editorial note: This commentary was written for The “New” Prostate Cancer InfoLink by Allen Edel.

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